Children in Monrovia, Liberia, lay on the ground Thursday while waiting to be admitted to an Ebola treatment center operated by Doctors Without Borders. They were brought to the center by ambulance from an Ebola isolation center that had been overrun by a mob.

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John Moore
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ATLANTA — Calling it a “miraculous day,” a Fort Worth doctor infected with the Ebola virus left his isolation unit and warmly hugged his doctors and nurses Thursday, showing the world that he poses no public health threat one month after getting sick.

Dr. Kent Brantly and fellow medical missionary Nancy Writebol, who was quietly discharged Tuesday, are still weak but should recover completely, and no one should fear being in contact with them, said Dr. Bruce Ribner, who runs the infectious disease unit at Emory University Hospital.

Brantly’s reappearance was festive and celebratory, a stark contrast to his arrival in an ambulance under police escort three weeks earlier, when he shuffled into the hospital wearing a bulky white hazardous materials suit.

“I am thrilled to be alive, to be well, and to be reunited with my family,” Brantly said, choking up as he read a prepared statement. “As a medical missionary, I never imagined myself in this position.”

He asked for prayer for those in West Africa, and then with his wife hugged or shook hands with a parade of doctors. For some, it was their first direct contact without protective gear.

After Brantly, 33, and Writebol, 59, were infected while working with Ebola victims in Liberia, their charity organizations, Samaritan’s Purse and SIM, reached out to top infectious disease experts for help.

Working connections, they obtained one of only five courses available worldwide of an experimental drug known as ZMapp, and Brantly and Writebol split the dose before being evacuated to Atlanta. The four other doses were later given to a Spanish priest, who died, and three health workers in Africa.

Writebol was not present for Brantly’s news conference. Her husband, David Writebol, said in a prepared statement that his wife is free of the virus, “but the lingering effects of the battle have left her in a significantly weakened condition.”

Bracing for the worst

Brantly didn’t take questions, but he did briefly describe how he and other aid workers confronted Ebola in Liberia. He said they had begun “preparing for the worst” after learning of the outbreak in March. After seeing their first patient in June, many others soon arrived.

He said his team took all the precautions it could. After his wife and children returned to the U.S. for a family wedding, he focused on work, moving patients to a bigger isolation unit. Three days later, he woke up feeling sick and was diagnosed with the disease.

“As I lay in my bed in Liberia for the following nine days, getting sicker and weaker each day, I prayed that God would help me to be faithful even in my illness,” Brantly said. “Through the care of the Samaritan’s Purse and SIM missionary team in Liberia, the use of an experimental drug, and the expertise and resources of the health care team at Emory University Hospital, God saved my life.”

His doctors cautioned that it’s unclear whether the drug or a blood transfusion Brantly got from a young Ebola survivor in Africa was helpful.

“Experimental means exactly that. They are the very first individuals to have received this treatment, and frankly we do not know,” Ribner said.

Brantly and Writebol were discharged after their medical team made sure they won’t infect others.

Their blood tested clean of the virus, which is spread only through direct contact with the bodily fluids of sick people experiencing symptoms. Survivors generally are not contagious once they’ve recovered.

Both Brantly and the Writebols asked for time alone.

“My family and I will now be going away for a period of time to reconnect, to decompress and to continue to recover physically and emotionally,” Brantly said.

David Writebol said his wife was recuperating at an undisclosed location.

Gap in care

There is a huge gap between the top-flight care these Americans got at Emory, where a crew of five infectious disease experts and 21 nurses provided rigorous care, and West Africa, where the virus has killed more than 1,300 people and counting, and even such basics as sterile fluids can be in short supply.

At least 2,473 people have been sickened in the outbreak — more than the caseloads of the previous two dozen Ebola outbreaks combined, according to the World Health Organization.

Treating the two patients has already given doctors insights into how to better care for Ebola patients anywhere. For example, they now believe common fluid-replacement measures may not have enough of certain nutrients patients need to recover.

Ribner said he had “no clue how much they might have spent” saving the missionaries’ lives, but he insisted that bringing them to Atlanta “was the right decision.”

“We cannot let our fears dictate our actions,” he said.

The Associated Press,

The New York Times,

Atlanta-Journal Constitution

Q&A: About the medical missionaries’ recovery

Both Dr. Kent Brantly and Nancy Writebol got an experimental treatment. Did it work?

Brantly credited his recovery to a number of things, including the experimental ZMapp drug. But Emory doctors and government health officials said it’s simply not known whether ZMapp helped them get better, made no difference or hindered their recovery.

Didn’t Brantly get a blood transfusion, too?

Before he left Africa, Brantly was given blood from a 14-year-old boy who survived Ebola while in his care. The intent was to provide Brantly with antibodies to help fight the infection. And again, like ZMapp, doctors simply don’t know if it had any effect.

What cured them?

There’s no simple answer. Since there’s no specific treatment, care is focused on easing symptoms to give the body enough time to fight off an infection. Patients are given fluids, nutrients and medicines to counter the bleeding, vomiting and severe diarrhea that can lead to organ failure and death. It probably helped that Brantly and Writebol were considered healthy and well-nourished before they were infected and received prompt care.

Do many people recover from Ebola?

Some do recover — and with far less aggressive treatment than Brantly and Writebol received in Atlanta. The mortality rate in the current outbreak in West Africa ranges from 30 percent to 90 percent depending on the area, according to the World Health Organization.

Can the Americans get Ebola again?

Doctors believe they are immune from the Ebola virus that’s caused the current outbreak in West Africa. They may not have much natural protection from other Ebola viruses, however.

The Associated Press

UPDATE: Hopes and fears on Ebola

WORRIES IN U.S.: Though health officials repeatedly have said the chance of a large Ebola outbreak in the U.S. is low, a survey released Thursday suggests Americans are worried. About 40 percent said they are very or somewhat concerned a large U.S. outbreak will occur within the next year. And 26 percent worry they or a family member will get sick. The Harvard School of Public Health surveyed 1,025 U.S. adults over the last week. The survey had a margin of error of plus or minus about 4 percentage points.

AID FOR LIBERIANS: Government officials handed out drinking water and bags of rice Thursday to residents of a slum in Liberia’s capital where tens of thousands of people have been barricaded in an effort to stop the spread of Ebola. Aid workers warned that much more help is needed.

3 WORKERS IMPROVE: Two Liberian health care workers — a doctor and a nurse — who received the experimental ZMapp medication to fight the Ebola virus have shown “marked improvement,” the World Health Organization said Thursday. A second doctor being treated with the drug remained in serious condition but “has improved somewhat,” the agency said.